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Self-pay in U.S. question

I don't know if this is the correct forum to place this question, but does anyone know, when you self-pay in the U.S., are you still required to meet minimum requirements to qualify for the surgery? You know the BMI, co-morbidites, psyc, pre-diet, etc...

From the research I've been doing, seems Mexico doesn't require these things.

Thanks for sharing your knowledge!

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Hi I am just starting the process in Ca. I do not meet the criteria of Kaiser BMI>40 or .35 with type 2 diabetes I have HTN and high cholesterol and my BMI is 36. Anyway I will still need to meet with a dietician and get a psyche eval. I forgot to ask about the prediet.

Where I am in Florida you do need the comorbidities with BMI of 35 or need a 40 BMI. The surgeon requires the psych eval and Nutritional appt(only one). But he does not require documented diet attempts. He also requires a liquid preop diet of 2 weeks for all is patients(to shrink the liver before surgery). Hope this helps.

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Yes, thank you very much! This is what I suspected from my research, but just haven't seen in writing. My research continues... I'm leaning towards going to Dr.Aceves in MX.

Thanks for sharing!

  • 3 weeks later...

Hello, I was self pay and I am 7 weeks out of surgery. I had the surgery in Idaho at a wonderful facility and great program. I had a BMI of 35.7, no co-morbidities, no medications, etc. I explained the diets I have done in my life and he scheduled my surgery that day. I paid $20K, but I had a friend pay about $17K 5 years ago, and since it was only 10 min from my house and they have an awesome after care program, classes, 3 month of free dietician and work outs 2x weekly with a personal trainer, etc I went for it! Good luck to you! I think going to Mexico sounds scary! (to be that far from home... anything closer to home, is Mexico cheaper?)

It depends on the surgeon. I had a BMI of 32, no significant co-morbidities (just a touch of high blood pressure, well controlled with medication). He did require a psych clearance but I was able to provide a letter from the therapist I've been seeing (for other issues) rather than do a full on psych eval. I paid $12,500 and was very happy with everything about it -- especially since it was only 15 minutes from home!

Oh, and because of my low BMI he didn't require any pre-op diet at all.

My surgeon didn't really go into his requirements for self-pays, but he did say that "Well between your BMI and a couple of co-morbidities, you'd definitely qualify through most insurance requirements," which I already knew, but I don't know if that's something he generally takes into consideration with self-pays or not. It would seem like he would. As for the pre-op stuff, I only needed clearance from my PCP, and the routine pre-op testing at the hospital. Oh, and no pre-op diet.

  • 2 weeks later...
  • 3 months later...

I had my surgery back in august in kcmo, cost 16k but all my all my pre surgery tests, lab work, all visits were covered until my 3 month visit and they had bliss insurance on me with it for 30 days just in case something happened. I actually had my surgery in a hospital, rather than a clinic.

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